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Kidney Week

Abstract: PO2270

Value of Immediate Post-Kidney Biopsy Ultrasound in Excluding Major Hemorrhagic Complications

Session Information

Category: Pathology and Lab Medicine

  • 1602 Pathology and Lab Medicine: Clinical

Authors

  • Albalas, Alian, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Almehmi, Ammar, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Almehmi, Sloan, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Allon, Michael, The University of Alabama at Birmingham, Birmingham, Alabama, United States
Background

Hemorrhage is the most serious potential complication of percutaneous kidney biopsy. Patients are typically observed for at least 6-8 hours after a kidney biopsy, with serial measurements of vital signs and hemoglobin to monitor for major hemorrhage. This study assessed whether an immediate post-biopsy ultrasound can reliably predict major hemorrhage.

Methods

We retrospectively evaluated the clinical outcomes in 147 patients undergoing an outpatient native kidney biopsy at a large medical center during a 2.5 year period (January 2017 to June 2019). All patients underwent a standardized post-biopsy ultrasound. We extracted from the medical records vital signs and hemoglobin values obtained before the biopsy and at 2, 4, and 6 hours after it, and ascertained whether the patient developed a major hemorrhage requiring hospitalization.

Results

Each patient underwent 2 or 3 biopsy passes. The mean patient age was 48±17 years, 49% were female, 37% were black, 53% had hypertension and 16% had diabetes. Five patients had evidence of a perinephric hematoma on the ultrasound and were hospitalized. The remaining 142 patients had no evidence of bleeding on ultrasound. Their blood pressure, heart rate, and hemoglobin remained stable during 6 hours of observation. All were discharged after 6 hours, and none had a late bleeding complication.

Conclusion

If the immediate post-kidney biopsy ultrasound does not show hemorrhage, the patient is extremely unlikely to develop a major hemorrhagic complication (negative predictive value, 100%). Such patients can be discharged home safely after a 2-hour observation, thereby simplifying their management.